Recommendations for Prevention and Control of Influenza in Children for the 2024-2025 Season

The current statement offers updates on the recommendations of the American Academy of Pediatrics (AAP) for the routine use of influenza vaccines and antiviral medications in the prevention and treatment of influenza in children during the 2024-2025 influenza season. 

General recommendations include the following:

1. The AAP recommends everyone aged 6 months and older, including children and adolescents, should receive the influenza vaccination during the 2024–2025 influenza season.
2. The AAP recommends any licensed influenza vaccine suitable for a child's age and health status, without preference for specific products, including inactivated (IIV) and live attenuated (LAIV) vaccines. For individuals aged 18 and older, recombinant influenza vaccine (RIV) is also an option. Healthcare providers are encouraged to administer whichever vaccine is appropriate and available to maximize influenza vaccination coverage for the season.
3. LAIV is not recommended for immunocompromised patients and individuals with some chronic medical conditions.
4. For the 2024–2025 influenza season, the recommended number of vaccine doses for children remains the same. Children aged 6 months to 8 years who are receiving the influenza vaccine for the first time, have only received one dose before July 1, 2024, or have unknown vaccination status should receive two doses at least 4 weeks apart. Doses given up to 4 days before the minimum suggested interval are acceptable. All other children in this age group should receive one dose. If an 8-year-old requires two doses, both should be administered even if the child turns 9 between the doses.
5. Children should receive the total number of full vaccine doses appropriate for their age. If a child is mistakenly given a formulation meant for older individuals, that dose is still considered valid. If a child aged 36 months or older receives a lower dose (e.g., 0.25 mL), an additional 0.25 mL should be given promptly to achieve the full 0.5 mL dose. Additionally, a 0.5 mL dose of any inactivated influenza vaccine (IIV) should not be divided into two 0.25 mL doses.
6. It is not necessary for the two vaccination doses to be of the same brand when a child is advised to have two doses within a specific season. If suitable for the child's age and health, a combination of IIV and LAIV may be administered.
7. Children should have access to the influenza vaccine as soon as it becomes available, especially those who are advised to receive two doses. For best protection prior to the start of the influenza season, the required dose or doses should ideally be received by the end of October. Due to the risk of declining immunity, most individuals, especially those over 65 and those who are pregnant in the first or second trimester, should not receive vaccinations in July and August in order to prevent waning immunity. Efforts to vaccinate against influenza should continue all season long.
8. Nirsevimab and other inactivated (nonlive) or live vaccinations may be given concurrently with or at any point before or after IIV (or RIV, if age-appropriate). Other live or inactivated (nonlive) vaccinations, such as the coronavirus disease 2019 (COVID-19) vaccine, may be given simultaneously with LAIV. If not administered together, LAIV should be given at least 4 weeks apart from other nonoral live vaccines. 

Source: Committee on Infectious Diseases. Recommendations for Prevention and Control of Influenza in Children, 2024-2025: Policy Statement. Pediatrics. 2024 Oct 1;154(4):e2024068507. doi: 10.1542/peds.2024-068507. PMID: 39183669.